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1861631020
BRIAN KINGSFORD
REXBURG, ID
NPI
1861631020
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: ID OT-482)
Enumeration Date
2009-02-11
Last Update Date
2018-11-26
Business Address
BRIAN KINGSFORD OT
393 E 2ND N
REXBURG, ID 83440-1605
Phone number: 208-359-9570
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Mailing Address
BRIAN KINGSFORD OT
36 PROFESSIONAL PLZ STE 110
REXBURG, ID 83440-2049
Phone number: 208-359-9570
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